Radical trachelectomy: The first step of fertility preservation in young women with cervical cancer (Review)

Abstract

Radical trachelectomy (RT) can be performed vaginally or abdominally (laparotomic, laparoscopic or robotic). The aim of this systematic review was to compare all techniques in terms of surgical complications, disease recurrence and subsequent fertility/pregnancy outcomes. A total of 1293 RTs were analyzed (FIGO-stage: IA1–IIA). The most frequent surgical complications do not differ from the ones of radical hysterectomy. The recurrence risk is approximately 3% (range 0–16.8%). The majority of women conceive spontaneously: 284 pregnancies with 173 live births. The most frequent pregnancy complication was miscarriage and chorioamnionitis. RT appears to be a safe option for eligible women who intend to maintain their future pregnancy desire.

Perioperative Outcomes of Radical Trachelectomy in Early-Stage Cervical Cancer: Vaginal Versus Laparoscopic Approaches

“…The intraoperative complication rate of vaginal radical trachelectomy reportedly varies from 1% to 13%, and the most frequent complication was ureteric damage. 7,16 Additionally, regarding the decline in postoperative hemoglobin in the LRT, the result of the study corresponded well with the results from other studies. 10,11 As the reports of LRT are limited and the study had a small cohort, perioperative outcomes were inconclusive.…”

“…Numerous reports have documented the feasibility and favorable outcomes of the procedure, with a tumor recurrence rate of 2.5% to 5.9% and a mortality rate of 2.5% to 3.2%. 7,8 However, radical vaginal surgery is difficult to learn especially in patients without prior vaginal birth. And there is a concern that vaginal trachelectomy is associated with possible incomplete parametrial resection.…”

A novel hysteroscopic approach for ovarian cancer screening/early diagnosis

“…Patients with a history of any neoplasia, hormonal adjuvant/replacement treatment (including selective estrogen receptor modulators or postmenopausal replacement therapy), adnexal surgery (including treatment for endometriosis, ectopic pregnancy and tubal ligation), absent tubal patency, Müllerian abnormalities, previous cervical surgery (cervical cone or multiple loop excisions and trachelectomy) (21,22) or abnormalities in psychological status will be excluded from the study.…”

Obstetric Outcomes and Complications After Vaginal Radical Trachelectomy: A Case Report

“…Cervical cancer is the third most commonly diagnosed gynecological cancer worldwide, 40% of which are diagnosed in women of childbearing age [1,2]. Traditionally, the standard of care for a patient diagnosed with cervical cancer is radical hysterectomy with pelvic lymphadenectomy or chemoradiotherapy, both of which will lead to loss of fertility potential.…”